Titanium nano-scale etching on an implant surface

ABSTRACT

A method of forming an implant to be implanted into living bone is disclosed. The method comprises the act of roughening at least a portion of the implant surface to produce a microscale roughened surface. The method further comprises the act of immersing the microscale roughened surface into a solution containing hydrogen peroxide and a basic solution to produce a nanoscale roughened surface consisting of nanopitting superimposed on the microscale roughened surface. The nanoscale roughened surface has a property that promotes osseointegration.

RELATED APPLICATIONS

This application is a continuation of U.S. patent application Ser. No. 13/074,670, filed Mar. 29, 2011, which claims the benefit of U.S. Provisional Application No. 61/318,641, filed Mar. 29, 2010, which is incorporated by reference in its entirety.

FIELD OF THE INVENTION

This invention relates generally to implants and, in particular, to a dental implant having a nanometer-scale surface topography and methods of making same.

BACKGROUND OF THE INVENTION

It is becoming more common to replace a missing tooth with a prosthetic tooth that is placed upon and attached to a dental implant. Dental implants are often comprised of metal and metal alloys, including titanium (Ti) and titanium alloys. The dental implant serves as an artificial root that integrates with the gingiva and the bone tissue of the mouth.

For the dental implant to function successfully, sufficient osseointegration is required. In other words, a bond between the implant and the bone must be formed and retained. The surface of the implant may be roughened to help enhance the osseointegration process. Non-limiting examples of processes for roughening an implant surface include acid etching and grit blasting, which impart roughness on the surface.

Other existing techniques involve forming a generally thin (e.g., generally less than 10 microns) coating of osseointegration materials, such as hydroxyapatite (HA), other calcium phosphates, or other osseointegration compounds, for forming a direct chemical compound between the implant and the bone. Plasma spraying and sputtering are two major techniques that have been used to deposit, for example, HA, onto an implant.

U.S. Pat. App. Pub. Nos. 2008/0220394, 2007/0110890, and 2007/0112353 disclose methods of discrete deposition of hydroxyapatite crystals to impart a nano-scale topography. Although effective, the disclosed processes require that a residual substance (i.e. HA crystals) be left on the surface post-processing in order to impart a nano-scale topography into the surface.

The present invention is directed to an improved implant having nanometer-scale surface topography directly imparted into the surface for improving the rate and extent of osseointegration, and methods of making the same.

SUMMARY OF THE INVENTION

The present invention relates to a method of forming an implant to be implanted into living bone. The method comprises the acts of roughening at least a portion of the implant surface to produce a microscale roughened surface. The method further comprises the act of immersing the microscale roughened surface into a solution containing hydrogen peroxide and a basic solution to produce a nanoscale roughened surface consisting of nanopitting superimposed on the microscale roughened surface.

In another aspect, another method of forming an implant to be implanted into living bone is disclosed. The method comprises the act of removing a native oxide layer from at least a portion of the implant surface. The method further comprises the act of roughening at least the portion of the implant surface to produce a microscale roughened surface. The method further comprises the act of rinsing the microscale roughened surface in deionized water. The method further describes the act of immersing the microscale roughened surface into a solution containing hydrogen peroxide and a basic solution at a high pH level to produce a nanoscale roughened surface consisting of nanopitting superimposed on the microscale roughened surface. The method further comprises the acts of passivating the nanoscale roughened surface with nitric acid, and rinsing the nanoscale roughened surface in deionized water.

The above summary of the present invention is not intended to represent each embodiment, or every aspect, of the present invention. This is the purpose of the figures and the detailed description which follow.

BRIEF DESCRIPTION OF THE DRAWINGS

The foregoing and other advantages of the invention will become apparent upon reading the following detailed description and upon reference to the drawings.

FIG. 1 is a side view of an implant according to one embodiment.

FIGS. 2 a, 2 b, and 2 c, are a side view, an insertion end view, and a gingival end view, respectively, of an implant according to a second embodiment.

FIGS. 3 a, 3 b, and 3 c, are a side view, an insertion end view, and a gingival end view, respectively, of an implant according to a third embodiment.

FIGS. 4 a and 4 b are a side view, an end view, and a cross-sectional view, respectively, of an implant according to a fourth embodiment.

FIG. 5 is a flow diagram detailing a method of forming an implant according to an embodiment of the present invention.

FIG. 6 is a side view of the implant in FIG. 1 with a roughened outer surface.

FIG. 7 a is a flow diagram detailing a method of forming an implant according to another embodiment of the present invention.

FIG. 7 b is a flow diagram detailing a method of forming an implant according to yet another embodiment of the present invention.

FIG. 8 a is a scanning electron microscope (SEM) image showing a commercially pure titanium implant post-acid etching at 2 kX.

FIG. 8 b is a field emission scanning electron microscope (FESEM) image showing a commercially pure titanium implant post-acid etching at 30 kX.

FIG. 9 a is an FESEM image showing a commercially pure titanium implant post-KOH/H₂O₂ treatment at 2 kX using a method of the present invention.

FIG. 9 b is an FESEM image showing a commercially pure titanium implant post-KOH/H₂O₂ treatment at 30 kX using a method of the present invention.

FIG. 9 c is an FESEM image showing a commercially pure titanium implant post-KOH/H₂O₂ treatment at 100 kX using a method of the present invention.

DETAILED DESCRIPTION OF THE INVENTION

The present invention is directed to implants having a nanometer scale surface topography consisting of irregular shaped pitting and methods of making the same. An implant in the context of the present invention means a device intended to be placed within a human body such as to connect skeletal structures (e.g., a hip implant) or to serve as a fixture for a body part (e.g., a fixture for an artificial tooth). Although the remainder of this application is directed to a dental implant, it is contemplated that the present invention may also be applied to other (e.g., medical) implants.

FIG. 1 shows a standard dental implant 10 that includes an head portion 12, a lowermost end 14, and a threaded bottom portion 16. The implant 10 may, for example, be made of titanium, tantalum, cobalt, chromium, stainless steel, or alloys thereof. FIGS. 2 a-c, 3 a-c, and 4 a-b, which are discussed below, describe alternative implant designs that may also be used with the present invention.

In the implant 10 of FIG. 1, the head portion 12 includes a non-rotational feature. In the embodiment shown, the non-rotational feature includes a polygonal boss 20 that may be engageable with a tool that screws the implant 10 into bone tissue. In the illustrated embodiment, the polygonal boss 20 is hexagonal. The polygonal boss 20 may also be used for non-rotationally engaging a correspondingly shaped socket on a restorative or prosthetic component that is attached to the implant 10.

The exterior of the threaded bottom portion 16 facilitates bonding with bone or gingiva. The threaded bottom section 16 includes a thread 18 that makes a plurality of turns around the implant 10. The threaded bottom portion 16 may further include a self-tapping region with incremental cutting edges 17 that allows the implant 10 to be installed without the need for a bone tap. These incremental cutting edges 17 are described in detail in U.S. Pat. No. 5,727,943, entitled “Self-Tapping, Screw-Type Dental Implant,” which is incorporated by reference in its entirety.

FIGS. 2 a-c disclose an implant 36 that differs from the implant 10 of FIG. 1 in the details of the cutting edges 17′ and the contours of the threads defining the exterior of the threaded bottom portion 16′. When viewed in the cross-section (see FIG. 1 b), the threaded outer surface 16′ is non-circular in the region of the threads and/or the troughs between the threads. This type of thread structure is described in detail in U.S. Pat. No. 5,902,109, entitled “Reduced Friction, Screw-Type Dental Implant,” which is incorporated by reference in its entirety.

In FIGS. 3 a-c, an implant 41 having a wide diameter in the region of the threaded bottom portion 42 is illustrated. The diameter is in the range of from about 4.5 mm to about 6.0 mm with the diameter of 5.0 mm being a fairly common dimension for a wide diameter implant. Such an implant 41 is useful to engage one or both cortical bones to provide enhanced stability, especially during the period of time after installation.

FIGS. 4 a-b illustrate an implant 110 according to another embodiment that may be used with the present invention. The implant 110 includes a middle section 114 designed to extend through the gingiva. Preferably, it is a smooth surface that includes a titanium nitride coating so the underlying titanium or titanium alloy is not readily seen through the gingiva. The implant 110 also includes a threaded portion 120 that may include various thread structures and is preferably roughened to increase the osseointegration process. It is contemplated that implants other than those illustrated in FIGS. 1-4 may be used with the present invention.

According to embodiments of the present invention, a nanoscale roughened surface is superimposed onto a microscale roughened surface on at least a portion (e.g., the threaded bottom portion) of the surface of an implant. In one embodiment, the nanoscale roughened surface is created by immersing the microscale roughened surface into a solution containing hydrogen peroxide and a basic solution. Non-limiting examples of suitable basic solutions include potassium hydroxide solutions and sodium hydroxide solutions.

Turning now to FIG. 5, a general method of producing a nanoscale roughened surface on an implant is set forth according to one embodiment of the present invention. At step 500, an implant is provided. At least a portion of the implant surface is roughened to a microscale roughness at step 501, for example, by machining, acid etching and/or grit blasting the implant surface. As an example, FIG. 6 shows the implant 10 of FIG. 1 having a roughened surface 630. Nanopitting is then created on the microscale roughened surface by immersion into a solution containing hydrogen peroxide and a basic solution, to produce a nanoscale roughened surface on the implant at step 502.

Referring now to FIG. 7 a, another general method of forming an implant according to another embodiment of the present invention is illustrated. An implant comprised of titanium, a titanium alloy (e.g. titanium 6AL-4V ELI alloy), stainless steel, or the like is provided at step 750. At step 754, nanopitting is created on a microscale roughened surface to produce a nanoscale roughened surface on the implant. At step 756, the implant is passivated with nitric acid. The implant may then be rinsed in reverse osmosis/deionized (RO/DI) water to remove residual solvents and hydroxyapatite at step 758. The implant is then dried at step 764 and sterilized at step 766 using, for example, gamma sterilization techniques.

Referring to FIG. 7 b, a more detailed method of producing a nanoscale roughened surface on an implant is illustrated according to another embodiment of the present invention. A threaded dental implant comprised of titanium, a titanium alloy (e.g. titanium 6AL-4V ELI alloy), stainless steel, or the like is provided at step 700. The surface of the implant is generally clean and dry. A threaded bottom portion of the implant is etched to remove a native oxide layer from the implant surface at step 701. The native oxide layer may be removed by a first acid solution, which may include aqueous hydrofluoric acid. The threaded bottom portion is then acid etched form a microscale roughened surface at step 702. “Microscale,” as used herein, should be understood to describe an article or feature generally measured in microns such as, for example, 1 micron to 100 microns. Acid etching may result from immersion in a mixture of sulfuric and hydrochloric acids, creating peak-to-peak and peak-to-valley irregularity distances in the microscale roughened surface of about 1 micron to 3 microns. This type of roughening method utilized on commercially pure (CP) titanium is described in detail in U.S. Pat. No. 5,876,453, entitled “Implant Surface Preparation,” which is incorporated by reference in its entirety. An additional roughening method utilized on Titanium 6AL-4V ELI alloy is described in detail in U.S. Pat. App. Pub. No. 2004/0265780, entitled “Surface Treatment Process for Implants Made of Titanium Alloy,” which is also incorporated by reference in its entirety. It is contemplated that other surface roughening techniques including, but not limited to, grit blasting, titanium plasma spraying, and combinations thereof, may be used. Grit blasting the threaded bottom portion to form a microscale roughened surface generally results in peak-to-peak and peak-to-valley irregularity distances of about 10 microns to 30 microns. Grit blasting and acid etching the threaded bottom portion to form the microscale roughened surface generally results in both levels of topographies, i.e., with about 1 micron to 3 microns peak-to-peak and peak-to-valley irregularity distances superimposed on 10 microns to 30 microns peak-to-peak and peak-to-valley irregularity distances on the microscale roughened surface.

At step 703, the microscale roughened surface is immersed into a solution containing hydrogen peroxide and a basic solution to produce a nanoscale roughened surface consisting of nanopitting superimposed on the microscale roughened surface. The basic solution can be any base with a pH in the range of about 7 to about 14, and preferably about 14, such as potassium hydroxide or sodium hydroxide. “Nanoscale,” as used herein, should be understood to describe an article or feature generally measured in nanometers such as, for example, 1 nanometer to 500 nanometers. Generally, immersion into the hydrogen peroxide/basic solution results in nanopitting of about 1 nanometer to about 100 nanometers.

Immersion time, hydrogen peroxide concentration, and basic solution concentration are among several factors that affect the rate and amount of nanopitting superimposed onto the microscale roughness of the implant surface. For example, immersing a commercially pure titanium implant in a solution of 3-5% potassium hydroxide and 13-22% hydrogen peroxide for 1 minute at 50 degrees Celsius typically results in an acceptable nanoscale roughness of the implant surface. Longer immersion times may impact the micron level topographies, while potassium hydroxide concentrations of less than 3% and/or hydrogen peroxide concentrations of less than 13% may result in the nano-topography not being adequately formed.

Another factor affecting the rate and amount of nanopitting onto the microscale roughness of the implant surface is the processing temperature. At temperatures of higher than about 60 degrees Celsius, for example, the etching is accelerated and can begin to impact the micron level topographies. Thus, it may be desirable for the processing temperature to be maintained at or below about 60 degrees Celsius.

Processing temperature, immersion time, and/or chemical concentration may be adjusted to compensate for one or more of these variables being within an otherwise unacceptable range, in order to nevertheless produce acceptable nano-topography. For example, potassium hydroxide concentrations of less than 3% may be adjusted by increasing immersion time and/or processing temperature in order to produce an acceptable amount of nanopitting on the microscale roughness of the implant surface.

Post-processing, the implant is passivated with nitric acid at step 704. At step 705, the implant is rinsed in hot deionized water (e.g. 70 degrees Celsius to 100 degrees Celsius) to remove any acid residuals and to potentially enhance titanium hydroxide groups on the surface.

Hydroxyapatite (HA) nanocrystals may then optionally be deposited on the nanoscale roughened surface of the implant at step 706. The HA nanocrystals may be introduced onto the nanoscale roughened surface of the implant in the form of a colloid. A representative amount of HA in the colloid is typically in the range of about 0.01 weight percent to about 1 weight percent (e.g., 0.10 weight percent). To form the colloid, HA nanocrystals may be combined in solution with a 2-methoxyethanol solvent and ultrasonically dispersed and deagglomerated. The pH of the colloidal solution may be adjusted with sodium hydroxide, ammonium hydroxide, or the like on the other of about 7 to about 13. As such, the colloidal solution may include HA nanocrystals, 2-methoxyethanol, and a pH adjuster (e.g. ammonium hydroxide, and/or sodium hydroxide). This type of HA deposition is described in detail in U.S. Pat. App. Pub. Nos. 2007/0110890 and 2007/0112353, both entitled “Deposition of Discrete Nanoparticles on an Implant Surface,” which are incorporated by reference in their entireties. The implant may then be rinsed in reverse osmosis/deionized (RO/DI) water to remove residual solvent and HA at step 708.

Alternatively or in addition to the acts of depositing HA nanocrystals at step 706 and rinsing at step 708, a sodium lactate coating may be applied on the nanoscale roughened surface of the implant at step 707 and the implant rinsed at step 708. In either embodiment, the implant may then be dried (e.g., oven dried), at step 714, and sterilized at step 716 using, for example, gamma sterilization.

The implant surface may be characterized utilizing Field Emission Scanning Electron microscopy (FESEM). Depending upon the resolution of the instrument, the nanopitting may typically be witnessed at magnifications of 30 kX or higher. As discussed above, the nanopitting generally has a distribution in the range of about 1 nanometer to about 500 nanometers, and typically between about 1 nanometer and about 100 nanometers.

EXAMPLE 1

FIGS. 8 a and 8 b are scanning electron microscope images showing a micron-level roughness imparted by an acid etching process on a commercially pure titanium implant. The image of FIG. 8 a was taken at 2 kX utilizing an SEM. The image of FIG. 8 b was taken at 30 kX utilizing an FESEM.

The implant shown in FIGS. 8 a and 8 b was machined, cleaned, and acid etched to impart a microscale roughness on the surface of the implant using a process similar to that described in U.S. Pat. No. 5,603,338, herein incorporated by reference in its entirety. The native oxide layer of the implant was removed via immersion in a hydrofluoric acid solution of about 5% v/v (about 8.5% w/w) for about 60 seconds at about 20-25 degrees Celsius. The acid etching was accomplished by immersion in an H₂SO₄/HCl solution for about 7 minutes at about 60-70 degrees Celsius. FIG. 8 a demonstrates the micron-level topography imparted by this acid etching at a magnification of 2 kX. Characteristic 1-3 micron peak-to-peak micropitting is clearly defined. FIG. 8 b, which is an FESEM image of the surface at a magnification of 30 kX, demonstrates the general lack of nanometer-scale surface roughness features after this level of processing.

The implant was then immersed in about 4% w/w potassium hydroxide and about 16% w/w hydrogen peroxide at a starting temperature of about 50 degrees Celsius for about 1 minute, according to one embodiment of the invention. Post-processing, the implant was thoroughly rinsed in de-ionized water, then passivated through 40 kHz ultrasonic immersion in about 22% w/w nitric acid for about 10 minutes at about 60 degrees Celsius, followed by additional rinsing in de-ionized water, and oven drying at about 100-150 degrees Celsius.

The additional processing imparted a nanometer level topography, as demonstrated in the FESEM images of FIGS. 9 a-c. FIG. 9 a, which is an FESEM image at a magnification of 2 kX, demonstrates the micron-level roughness imparted by the acid etching remains on the implant, including the characteristic 1-3 micron peak-to-peak micropitting. The nanoscale roughness cannot be witnessed at this magnification.

FIG. 9 b, which shows the surface of FIG. 9 a at a magnification of 30 kX, demonstrates the nanoscale roughness features of the implant surface. Nanopitting in the 1-100 nanometer range can be witnessed at this magnification. FIG. 9 c, which is a magnification of the surface of FIGS. 9 a and 9 b at 100 kX, more clearly demonstrates the resultant nanoscale roughness.

The implant shown in FIGS. 9 a-c was then evaluated for surface chemistry utilizing Electron Dispersion Spectroscopy. A spot size of approximately 275×375 microns was analyzed for chemistry. The freshly processed and passivated sample demonstrated a 100% titanium surface chemistry, indicating that no residuals were present at the detection limit of the instrument.

EXAMPLE 2

All of the solutions containing the concentrations of KOH and H₂O₂ provided in Table 1 below resulted in acceptable nano-topography on commercially pure titanium with about 1 minute exposure to a hydrogen peroxide and potassium hydroxide solution at about 50 degrees Celsius:

TABLE 1 Concentrations of KOH and H₂O₂ % KOH % H₂O₂ 4 16 4 19 4 22 3 16 3 19 5 13 5 19

A solution having about 4% w/w KOH and about 16% w/w H₂O₂ resulted in acceptable nano-topography on titanium 6AL-4V ELI with 1 minute exposure to a hydrogen peroxide and potassium hydroxide solution at about 50 degrees Celsius.

A solution having about 4% w/w NaOH and about 16% w/w H₂O₂ resulted in acceptable nano-topography on titanium 6AL-4V ELI with about 1 minute exposure to a hydrogen peroxide and sodium hydroxide solution at about 50 degrees Celsius.

EXAMPLE 3

All of the solutions containing the concentrations of KOH and H₂O₂ provided in Table 2 below, with KOH and H₂O₂ concentrations ranging from about 1% w/w to about 6% w/w resulted in acceptable nano-topography on grit-blasted and acid-etched commercially pure titanium with about 4 minute exposure to a hydrogen peroxide and potassium hydroxide solution at about 33 degrees Celsius.

TABLE 2 Concentrations of KOH and H₂O₂ % KOH % H₂O₂ 4 1 4 2 4 3 4 4 4 5 4 6 1 4 2 4 3 4 5 4 6 4

The solutions containing the concentrations of KOH and H₂O₂ provided in Table 2 slow down the method of forming acceptable nano-topography, thus improving process control in the production environment. As the base or peroxide concentration approached 0% w/w, the desired surface topography was not formed.

It is contemplated that various combinations of variables (e.g., concentration of basic solution, concentration of hydrogen peroxide, exposure times, temperatures) may be used to forms the desired surface attributes. According to one non-limiting example, the desired surface may be obtained using 4.1% KOH, 3.85% H₂O₂, 3 minute exposure time, and 31 degrees Celsius.

While the present invention has been generally described relative to the part of the implant contacting bone tissue, it is contemplated that the acts of etching, acid etching, roughening, nanopitting, and depositing herein described may be performed on the entire implant.

While the present invention has been described with reference to one or more particular embodiments, those skilled in the art will recognize that many changes may be made thereto without departing from the spirit and scope of the present invention. Each of these embodiments and obvious variations thereof is contemplated as falling within the spirit and scope of the claimed invention, which is set forth in the following claims. 

What is claimed is:
 1. A method of forming an implant to be implanted into living bone, the method comprising the acts of: roughening at least a portion of the implant surface to produce a first topography; further roughening the implant surface to produce a second topography superimposed on the first topography; and providing a nanoscale topography superimposed on the first and second topographies.
 2. The method of claim 1, wherein the implant is made of a metal selected from the group consisting of tantalum, cobalt, chromium, titanium, stainless steel, or alloys thereof.
 3. The method of claim 1, wherein the implant is a dental implant.
 4. The method of claim 3, wherein the portion of the implant surface is a threaded bottom portion for facilitating bonding with bone.
 5. The method of claim 1, wherein the act of roughening the implant surface to produce the first topography comprises grit blasting the surface.
 6. The method of claim 5, wherein the first topography includes peak-to-valley irregularity distances of about 10 microns to about 30 microns.
 7. The method of claim 1, wherein the implant is made of titanium and the act of roughening the implant surface to produce the second topography comprises: removing a native oxide layer from the implant surface; and acid etching the resulting surface.
 8. The method of claim 7, wherein the act of acid etching the surface includes using a solution including sulfuric acid and hydrochloric acid.
 9. The method of claim 7, wherein the second topography includes peak-to-valley heights of less than about 10 microns and peak-to-peak distances of less than about 3 microns.
 10. The method of claim 1, wherein the act of providing a nanoscale topography includes immersing the implant in a solution including a basic solution to produce a nanoscale roughened surface including nanopitting.
 11. The method of claim 10, wherein the solution further comprises hydrogen peroxide.
 12. The method of claim 10, wherein the basic solution is a sodium hydroxide solution.
 13. The method of claim 10, wherein the basic solution is a potassium hydroxide solution.
 14. The method of claim 13, wherein the potassium hydroxide solution has a concentration of about 3-5% w/w and the hydrogen peroxide has a concentration of about 13-22% w/w.
 15. The method of claim 13, wherein the potassium hydroxide solution has a concentration of about 1-6% w/w and the hydrogen peroxide has a concentration of about 1-6% w/w.
 16. The method of claim 10, wherein the basic solution has a pH between about 7 to about
 14. 17. The method of claim 10, wherein the nanopitting is in the range of about 1-100 nanometers.
 18. The method of claim 10, further comprising the acts of: rinsing the nanoscale roughened surface in deionized water; passivating the nanoscale roughened surface with nitric acid; re-rinsing the nanoscale roughened surface in deionized water; and drying the nanoscale roughened surface.
 19. The method of claim 1, wherein the act of providing a nanoscale topography includes the act of depositing discrete nanoparticles on the first and second topographies.
 20. The method of claim 1, further comprising the act of applying a sodium lactate coating on the nanoscale topography.
 21. A method of forming an implant to be implanted into living bone, the method comprising the acts of: grit blasting at least the portion of the implant surface to produce a first roughened surface including peak-to-valley heights of about 10 microns to about 30 microns; acid etching the grit blasted surface to produce a second roughened surface having peak-to-valley heights of less than about 10 microns superimposed on the first roughened surface; and providing a nanoscale topography superimposed on the second roughened surface.
 22. The method of claim 21, wherein the acid etching includes etching the implant surface with a solution including sulfuric acid and hydrochloric acid.
 23. The method of claim 21, wherein the implant is made of a metal selected from the group consisting of tantalum, cobalt, chromium, titanium, stainless steel, or alloys thereof.
 24. The method of claim 21, wherein the implant is a dental implant.
 25. The method of claim 21, wherein the act of providing a nanoscale topography includes immersing the implant in a solution including hydrogen peroxide and a basic solution to produce a nanoscale roughened surface including nanopitting.
 26. The method of claim 25, wherein the solution further comprises hydrogen peroxide.
 27. The method of claim 25, wherein the basic solution is a sodium hydroxide solution.
 28. The method of claim 25, wherein the basic solution is a potassium hydroxide solution having a concentration of about 3-5% w/w and the hydrogen peroxide has a concentration of about 13-22% w/w.
 29. The method of claim 25, wherein the basic solution is a potassium hydroxide solution having a concentration of about 1-6% w/w and the hydrogen peroxide has a concentration of about 1-6% w/w.
 30. The method of claim 21, wherein the act of providing a nanoscale topography includes depositing discrete nanoparticles on the second roughened surface.
 31. The method of claim 21, further comprising the act of applying a sodium lactate coating on the nanoscale topography. 